Driving with Low Vision Bill Takeshita, O.D.,F.A.A.O., F.C.O.V.D.
-
Upload
aubrie-maude-harrison -
Category
Documents
-
view
219 -
download
0
Transcript of Driving with Low Vision Bill Takeshita, O.D.,F.A.A.O., F.C.O.V.D.
![Page 1: Driving with Low Vision Bill Takeshita, O.D.,F.A.A.O., F.C.O.V.D.](https://reader034.fdocuments.in/reader034/viewer/2022051315/56649da05503460f94a8b2de/html5/thumbnails/1.jpg)
Driving with Low Vision
Bill Takeshita, O.D.,F.A.A.O., F.C.O.V.D.
![Page 2: Driving with Low Vision Bill Takeshita, O.D.,F.A.A.O., F.C.O.V.D.](https://reader034.fdocuments.in/reader034/viewer/2022051315/56649da05503460f94a8b2de/html5/thumbnails/2.jpg)
DMV 962 Form
• People with low vision are eligible to apply for drivers license
• Requires a special vision examination and the completion of the DMV 962 form by a low vision optometrist or ophthalmologist
• Written and road tests
![Page 3: Driving with Low Vision Bill Takeshita, O.D.,F.A.A.O., F.C.O.V.D.](https://reader034.fdocuments.in/reader034/viewer/2022051315/56649da05503460f94a8b2de/html5/thumbnails/3.jpg)
Low Vision Examination
• Determine the functional strengths and weaknesses of the patient
• Design optical aids to maximize the patient’s remaining vision
• Develop treatment program to address functional problems
• Work with allied professionals
![Page 4: Driving with Low Vision Bill Takeshita, O.D.,F.A.A.O., F.C.O.V.D.](https://reader034.fdocuments.in/reader034/viewer/2022051315/56649da05503460f94a8b2de/html5/thumbnails/4.jpg)
Eye Movement Testing
• Fixation: Ability to keep eyes steady on the target. Nystagmus is the uncontrollable shaking of the eyes.
• Versions or pursuits: Ability to follow a moving target (Parietal lobe of brain)
• Saccades: Ability to shift the eyes from one target to another, such as when reading. (Front lobe of brain).
• Eye-hand coordination testing
![Page 5: Driving with Low Vision Bill Takeshita, O.D.,F.A.A.O., F.C.O.V.D.](https://reader034.fdocuments.in/reader034/viewer/2022051315/56649da05503460f94a8b2de/html5/thumbnails/5.jpg)
Convergence Testing
• Convergence is the ability to cross or bring both eyes together when reading.
• Poor convergence is a leading cause of the inability to read
• Double vision• Headaches• Loss of place when
reading
![Page 6: Driving with Low Vision Bill Takeshita, O.D.,F.A.A.O., F.C.O.V.D.](https://reader034.fdocuments.in/reader034/viewer/2022051315/56649da05503460f94a8b2de/html5/thumbnails/6.jpg)
Depth Perception
• Photograph of stereo test
![Page 7: Driving with Low Vision Bill Takeshita, O.D.,F.A.A.O., F.C.O.V.D.](https://reader034.fdocuments.in/reader034/viewer/2022051315/56649da05503460f94a8b2de/html5/thumbnails/7.jpg)
Color Vision
• Photo of color vision test
![Page 8: Driving with Low Vision Bill Takeshita, O.D.,F.A.A.O., F.C.O.V.D.](https://reader034.fdocuments.in/reader034/viewer/2022051315/56649da05503460f94a8b2de/html5/thumbnails/8.jpg)
Contrast Sensitivity Testing
• Photo of Pelly Robson
• Photo of Vis Tek
![Page 9: Driving with Low Vision Bill Takeshita, O.D.,F.A.A.O., F.C.O.V.D.](https://reader034.fdocuments.in/reader034/viewer/2022051315/56649da05503460f94a8b2de/html5/thumbnails/9.jpg)
Peripheral Vision Testing
• Photo of Humphrey
• Test of finger confrontation
![Page 10: Driving with Low Vision Bill Takeshita, O.D.,F.A.A.O., F.C.O.V.D.](https://reader034.fdocuments.in/reader034/viewer/2022051315/56649da05503460f94a8b2de/html5/thumbnails/10.jpg)
Amsler Grid Central Vision Test
• Photo of Amsler Grid test
![Page 11: Driving with Low Vision Bill Takeshita, O.D.,F.A.A.O., F.C.O.V.D.](https://reader034.fdocuments.in/reader034/viewer/2022051315/56649da05503460f94a8b2de/html5/thumbnails/11.jpg)
Distance Acuity
• Photo of ETDRS
• Photo of Feinbloom
![Page 12: Driving with Low Vision Bill Takeshita, O.D.,F.A.A.O., F.C.O.V.D.](https://reader034.fdocuments.in/reader034/viewer/2022051315/56649da05503460f94a8b2de/html5/thumbnails/12.jpg)
Refraction
• Illustration of perspective with e on macula
![Page 13: Driving with Low Vision Bill Takeshita, O.D.,F.A.A.O., F.C.O.V.D.](https://reader034.fdocuments.in/reader034/viewer/2022051315/56649da05503460f94a8b2de/html5/thumbnails/13.jpg)
Telescopic Refraction
• Specialized technique to determine best spectacle correction
• Focus light on the healthiest region of retina for eccentric viewing
![Page 14: Driving with Low Vision Bill Takeshita, O.D.,F.A.A.O., F.C.O.V.D.](https://reader034.fdocuments.in/reader034/viewer/2022051315/56649da05503460f94a8b2de/html5/thumbnails/14.jpg)
Visual Status
• World Health Organization and Social Security Administration
• Fully Sighted
• Partially Sighted
• Legally Blind
• Functionally Blind
![Page 15: Driving with Low Vision Bill Takeshita, O.D.,F.A.A.O., F.C.O.V.D.](https://reader034.fdocuments.in/reader034/viewer/2022051315/56649da05503460f94a8b2de/html5/thumbnails/15.jpg)
Legal Blindness
• Visual acuity of 20/200 or worse in the BETTER eye with glasses or contact lenses
• Widest field of vision 20 degrees or smaller in the better eye with corrective glasses or contact lenses
• May qualify for audio books, Social Security, transportation discounts, Medicare
![Page 16: Driving with Low Vision Bill Takeshita, O.D.,F.A.A.O., F.C.O.V.D.](https://reader034.fdocuments.in/reader034/viewer/2022051315/56649da05503460f94a8b2de/html5/thumbnails/16.jpg)
Bioptic Telescopes
• 4x Full Diameter TS Not focusable
• Spiral focusable TS
• Expanded field focus TS (note: length)
![Page 17: Driving with Low Vision Bill Takeshita, O.D.,F.A.A.O., F.C.O.V.D.](https://reader034.fdocuments.in/reader034/viewer/2022051315/56649da05503460f94a8b2de/html5/thumbnails/17.jpg)
Ocutech Bioptic
• Cosmetically more appealing
• Autofocus option
• Slightly dimmer than DVI BTS
• Smaller field of view than DVI BTS
![Page 18: Driving with Low Vision Bill Takeshita, O.D.,F.A.A.O., F.C.O.V.D.](https://reader034.fdocuments.in/reader034/viewer/2022051315/56649da05503460f94a8b2de/html5/thumbnails/18.jpg)
Special Lens Materials
• Eschenbach Novus
• Super Modular
• Hyper 1.67
• Trivex
![Page 19: Driving with Low Vision Bill Takeshita, O.D.,F.A.A.O., F.C.O.V.D.](https://reader034.fdocuments.in/reader034/viewer/2022051315/56649da05503460f94a8b2de/html5/thumbnails/19.jpg)
Polarized Prescription Filters
• Provide the most features for the patient
• UV filtration• Eliminate reflected glare from
concrete, windshields, water• Many colors to reduce glare but
not cut out so much light that one cannot see
• Available in prescriptions, bifocals, and progressive addition lenses
![Page 20: Driving with Low Vision Bill Takeshita, O.D.,F.A.A.O., F.C.O.V.D.](https://reader034.fdocuments.in/reader034/viewer/2022051315/56649da05503460f94a8b2de/html5/thumbnails/20.jpg)
UV Shield and NoIR Filters
• UV shields
• Solar Shields
• NoIR
• Spectra Shields
![Page 21: Driving with Low Vision Bill Takeshita, O.D.,F.A.A.O., F.C.O.V.D.](https://reader034.fdocuments.in/reader034/viewer/2022051315/56649da05503460f94a8b2de/html5/thumbnails/21.jpg)
Cocoon Filters
• Photo of cocoon filters
![Page 22: Driving with Low Vision Bill Takeshita, O.D.,F.A.A.O., F.C.O.V.D.](https://reader034.fdocuments.in/reader034/viewer/2022051315/56649da05503460f94a8b2de/html5/thumbnails/22.jpg)
Grey Filters
• Work well for those patients who are bothered by direct sunlight
• Does not distort color vision
• May be too dark for some patients
• Helpful for mobility during sunny days
• Gradient gray tints are also helpful for many patients
![Page 23: Driving with Low Vision Bill Takeshita, O.D.,F.A.A.O., F.C.O.V.D.](https://reader034.fdocuments.in/reader034/viewer/2022051315/56649da05503460f94a8b2de/html5/thumbnails/23.jpg)
Green filters
• Bausch and Lomb G-15
• Some patients may prefer this color over the grey lens
• Some patients with glaucoma and optic nerve problems appreciate this color lens
• G-15 color can be made in plastic
• Red/green color deficiency may appreciate the green filter
![Page 24: Driving with Low Vision Bill Takeshita, O.D.,F.A.A.O., F.C.O.V.D.](https://reader034.fdocuments.in/reader034/viewer/2022051315/56649da05503460f94a8b2de/html5/thumbnails/24.jpg)
Blue Free Filters
• Brown, orange, amber, and yellow filter the blue wavelengths of light
• Corning CPF (glass)
• Increase the contrast of images
• Some patients may report that things are brighter
• Macular degeneration, diabetic retinopathy, retinitis pigmentosa
![Page 25: Driving with Low Vision Bill Takeshita, O.D.,F.A.A.O., F.C.O.V.D.](https://reader034.fdocuments.in/reader034/viewer/2022051315/56649da05503460f94a8b2de/html5/thumbnails/25.jpg)
PRL Training
• Teach the patient to move his or her eyes to allow the image to focus on the healthier regions of the retina.
• Eccentric viewing training
• Takes a lot of time and patience
![Page 26: Driving with Low Vision Bill Takeshita, O.D.,F.A.A.O., F.C.O.V.D.](https://reader034.fdocuments.in/reader034/viewer/2022051315/56649da05503460f94a8b2de/html5/thumbnails/26.jpg)
Macular Scar
• Photo of macular scar
Can you read this?